TIP OF THE WEEK

There are a lot of really young mothers in the news right now. I’ve had some reader emails lately from teens in various parts of the world asking some really heartfelt questions. I went to the National CARE Conference this month where the focus was on maternal mortality and child marriage. Finally, Bristol Palin is making the rounds of the media circuit talking about abstinence and avoiding teen pregnancy, though she’s also adamant about how much she loves being a mother. Teenagers aren’t a crazy-practical bunch. What they lack in foresight and maturity makes them vulnerable and yet so determined to be good parents.

Amanda wants to know if her pregnancy is "high risk" because she’s 15. Yes, honey, it is. Your body’s not fully grown yet and while the chances are excellent you’ll carry your baby to full term and proceed through labor and delivery without a hitch, you’re still a kid. Kids’ bodies aren’t supposed to have babies yet.

The American College of Obstetricians and Gynecologists says, "Pregnant teens are at more risk for certain health problems like high blood pressure, premature labor and/or anemia than older women. These risks are even greater for teens younger than age 15 years or those who don’t get prenatal care."

I had a patient who was a tiny slip of a girl. She was 14 and built like a 12-year-old. Her boyfriend, the baby’s father, was well over six feet tall and was, in fact, a linebacker. She labored easily, dilating to 10 centimeters fairly quickly. She handled labor elegantly, especially considering how many teenagers act like children (because they are) with squabbles and tantrums. This patient, however, buckled down to labor with the support of her own mother. They made a nice team.

Then came the pushing stage…. She pushed and pushed and just couldn’t get that baby out. She finally had a C-section and a well-deserved melt down. She freaked out about the incision ruining her (entirely stretch mark-free) tummy; about the pain, the operating room, the anesthesia, everything. Poor little girl was just plain scared. We calmed her down and got her own mommy into the operating room ASAP. Once she was over her anxiety, she had a relatively easy, painless C-section and delivered a big baby boy who had Dad’s build – a baby linebacker.

A reader from Africa says she got married "young" and is expecting her first baby. She didn’t say how young but says she knows she can be a good wife and mother. She wants to know how to make labor less painful and how she can be sure she’ll get a boy. Oh my.

I know nothing about this girl’s circumstances. I can only discuss what things are like for other girls who marry while still children. An 8-year-old girl from Yemen has been in the news lately because she was finally granted a divorce from the 30-year-old man who her father forced her to marry. We’re all shocked by the conditions this poor child lived with for two months before gaining protection in court. She’s not unique, though, as I learned at the CARE convention. More than 60 million girls under age 17 are married. That sets them up for all kinds of problems: increased maternal mortality and physical disability, decreased educational and employment opportunities and a strong likelihood she and her children will continue the cycle of poverty that often forces them into marriage in the first place.

What can my reader do to decrease labor pain? Get prenatal care if it’s accessible. She may or may not (it sounds like not) have access to pain management (medicine or epidural) during labor so she’ll have to go with traditional routes as taught her by the women in her life – breathing, relaxation, visualization. It works for a whole lot of women in the world.About guaranteeing a boy? That’s entirely up to the genetics provided by Dad’s sperm - the luck of the draw. We women have no say in the matter. Very few women have access to infertility-based prenatal care that gene-selects for a specific gender, but most don’t. It makes me sad that anyone these days has a preference for a boy over a girl. Most mothers are thrilled with whomever they get, unless their culture refuses to support and value girls. What’s CARE doing about this? They’re asking for US leadership by passing "The International Protecting Girls by Preventing Child Marriage Act."US Senators and Congressmen stepped up sponsorship of this act and introduced the bill, right after the CARE convention.

How about Bristol? Bristol says abstinence is the way to go in avoiding teen pregnancy and she’s right, in part. The only guaranteed way to avoid getting pregnant is to "just say no." But if you say "yes," and many teens will, here’s what ACOG says: "The US continues to have the highest rate of teen pregnancy of any industrialized nation. The birth rate among US teens ages 15-19 was 42.5 per 1,000 in 2007, marking a 5% increase since 2005. This spike was observed across racial lines, with the exception of Hispanic teens, who experienced a 2% decrease. Experts believe the increase is partly due to abstinence-only sex education programs combined with decreased contraception education and use among teens." ACOG gets the last word on this.

To my teen readers – my heart goes out to you. I’m confident many of you will be wonderful mothers and you have all my support.

This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.